Intervention to Strengthen Emotional Self-Regulation in Children with Emerging Mental Health Problems: Proximal Impact on School Behavior

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Learning opportunities are focused on the dynamic and continually evolving range of knowledge and skills a child is capable of attaining under guidance from a competent adult.

“Influenced by the concepts of ‘scaffolding’ (Wood et al. 1976) and zone of proximal development (Vygotsky 1978), learning opportunities are focused on the dynamic and continually evolving range of knowledge and skills a child is capable of attaining under guidance from a competent adult.”

• cites Wood et al. 1976 sourceSupported
• cites Vygotsky 1978Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Peer social skills improved for girls but not for boys.

“Peer social skills improved for girls but not for boys.”

May combine two claims.

In models that tested for Level 2 (classroom-level) by intervention condition interactions, we found no evidence of a differential intervention impact associated with either mean classroom levels of child problems or with the number of children in a classroom who screened positive for the intervention.

“In models that tested for Level 2 (classroom-level) by intervention condition interactions, we found no evidence of a differential intervention impact associated with either mean classroom levels of child problems or with the number of children in a classroom who screened positive for the intervention.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All nine children receiving suspensions had different teachers.

“All nine children receiving suspensions had different teachers.”

May combine two claims.

For out-of-school suspensions, the intervention reduced both the propensity to have a suspension and the frequency.

“For out-of-school suspensions, the intervention reduced both the propensity to have a suspension and the frequency.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Sixty-six percent of teachers (39/59) made one or more referrals, with 86% of those referring making 1-3 referrals.

“Sixty-six percent of teachers (39/59) made one or more referrals, with 86% of those referring making 1–3 referrals.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Mean baseline Task Orientation scores were: group 3 (M=16.68, SD=4.21), group 1 (M=18.72, SD=7.23), and group 2 (M=24.47, SD=8.23).

“Mean baseline Task Orientation scores were: group 3 (M=16.68, SD=4.21), group 1 (M=18.72, SD=7.23), and group 2 (M=24.47, SD=8.23).”

May combine two claims.

Over two years, 285 children out of the population of kindergarten-3rd grade children 'screened positive' for elevated classroom problems, 261 enrolled in the intervention, and 226 (or 79% of all eligible) completed the four-month follow-up.

“Over two years, 285 children out of the population of kindergarten—3rd grade children ‘screened positive’ for elevated classroom problems, 261 enrolled in the intervention, and 226 (or 79% of all eligible) completed the four-month follow-up.”

Classified as probably not a substantial claim.

These considerations led to the selection of a three cluster solution.

“These considerations led to the selection of a three cluster solution.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Children in the intervention condition received an average of 12.2 lessons with interventionists (range 7-14).

“Children in the intervention condition received an average of 12.2 lessons with interventionists (range 7–14).”

Probably not a substantial claim: may not pass S3 (load-bearing).

The eight children receiving suspensions were in 7 different classrooms.

“The eight children receiving suspensions were in 7 different classrooms.”

May combine two claims.

Relative to controls, children receiving the intervention had a 46% mean decrease in office disciplinary referrals and a 43% decrease in mean suspensions during the 4-month intervention period.

“Relative to controls, children receiving the intervention had a 46% mean decrease in office disciplinary referrals and a 43% decrease in mean suspensions during the 4-month intervention period.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Mean Assertive vs. Withdrawn scores were: group 1 (M=21.92, SD=5.91), group 2 (M=31.14, SD=5.21), and group 3 (M=30.25, SD=4.76).

“Mean Assertive vs. Withdrawn scores were: group 1 (M=21.92, SD=5.91), group 2 (M=31.14, SD=5.21), and group 3 (M=30.25, SD=4.76).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Mean baseline Behavior Control scores were as follows: group 1 (M=20.58, SD=7.33), group 3 (M=20.25, SD=6.34), and group 2 (M=23.20, SD=8.07).

“Mean baseline Behavior Control scores were as follows: group 1 (M=20.58, SD=7.33), group 3 (M=20.25, SD=6.34), and group 2 (M=23.20, SD=8.07).”

May combine two claims.

Attrition was not associated with any baseline measure nor differentially predicted by condition as a function of any baseline variable.

“Attrition was not associated with any baseline measure nor differentially predicted by condition as a function of any baseline variable, i.e., no condition X baseline measure interactions.”

May combine two claims.

For girls, the intervention had a large effect on improved peer social skills (standardized ES=0.90), whereas social skills did not change for boys.

“For girls, the intervention had a large effect on improved peer social skills (standardized ES=0.90), whereas social skills did not change for boys.”

May combine two claims.

The average intervention effects were medium-sized and positive for Task Orientation (ES=0.33), Behavior Control (ES=0.31), Assertive vs. Withdrawn Behaviors (ES=0.37), and Peer Social Skills (ES=0.47).

“The average intervention effects (see Table 2, column 3) were medium-sized and positive for Task Orientation (ES=0.33), Behavior Control (ES=0.31), Assertive vs. Withdrawn Behaviors (ES=0.37), and Peer Social Skills (ES=0.47).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The mean number of referrals made by teachers was 1.88; 61% of teachers (36/59) made a referral, with 83% of those referring making 1-3 referrals.

“The mean number of referrals made by teachers was 1.88; 61% of teachers (36/59) made a referral, with 83% of those referring making 1–3 referrals.”

May combine two claims.

In the pre-intervention interval, 4.5% of children in the intervention group (5/111) were suspended versus 2.6% of controls (3/115), which was also a comparable suspension rate by intervention condition (OR: 1.87; 95% CI: 0.33, 10.48, p=0.48).

“In the pre-intervention interval, 4.5% of children in the intervention group (5/111) were suspended versus 2.6% of controls (3/115), which was also a comparable suspension rate by intervention condition (OR: 1.87; 95% CI: 0.33, 10.48, p=0.48).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Classroom-level variation on children's Behavior Control and Task Orientation was moderate.

“Classroom-level variation on children’s Behavior Control and Task Orientation was moderate (see intraclass correlations in column 4 of Table 2).”

May combine two claims.

The three groups had similar levels of behavior control problems and more substantial differences in other domains.

“The three groups had similar levels of behavior control problems and more substantial differences in other domains.”

May combine two claims.

In the 3-month pre-intervention interval, 30.6% of children in the intervention condition (34/111) had one or more office disciplinary referrals (range: 1-10) and 25.2% of controls (29/115) had one or more referrals (range: 1-9).

“In the 3-month pre-intervention interval, 30.6% of children in the intervention condition (34/111) had one or more office disciplinary referrals (range: 1–10) and 25.2% of controls (29/115) had one or more referrals (range: 1–9).”

May combine two claims.

Whereas 1.8% (2/111) of children in the intervention condition received a suspension up to a maximum of one time, 6.1% of controls (7/115) were suspended, with five suspensions being the maximum number.

“Specifically, whereas 1.8% (2/111) of children in the intervention condition received a suspension up to a maximum of one time, 6.1% of controls (7/115) were suspended, with five suspensions being the maximum number.”

May combine two claims.

The intervention improved peer social skills for girls but not for boys.

“We estimated our multi-level model testing intervention impact on Peer Social Skills separately for girls and boys; the intervention improved peer social skills for girls but not for boys.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Cluster group 1 was largest, comprised of 146 children (64.6% of the sample); groups 2 and 3 had 51 (22.6%) and 28 (12.4%) children, respectively.

“Cluster group 1 was largest, comprised of 146 children (64.6% of the sample); groups 2 and 3 had 51 (22.6%) and 28 (12.4%) children, respectively.”

May combine two claims.

Neither a child's baseline level of problems or grade was associated with differential intervention impact.

“Neither a child’s baseline level of problems or grade was associated with differential intervention impact.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Mean Peer Social Skills scores were: group 3 (M=17.75, SD=5.71), group 1 (M=22.07, SD=4.92), and group 2 (M=34.33, SD=3.34).

“Mean Peer Social Skills scores were: group 3 (M=17.75, SD=5.71), group 1 (M=22.07, SD=4.92), and group 2 (M=34.33, SD=3.34).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Those ICCs were larger for Behavior Control (0.13) than Task Orientation (0.07).

“Those ICCs were larger for Behavior Control (0.13) than Task Orientation (0.07).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Minimal transfer of new skills by children to settings outside the intervention context is a limitation.

“Minimal transfer of new skills by children to settings outside the intervention context is a limitation (Webster-Stratton and Hammond 1997)”

• cites Webster-Stratton and Hammond 1997 sourceNot checked — no full text of the source

May combine two claims.

The evaluation focused on a representative subgroup of children, which minimizes selection bias and strengthens inferences about intervention effects.

“Guided by a developmental epidemiology prevention approach (Kellam et al. 1999), our evaluation focused on a representative subgroup of children, which minimizes selection bias and strengthens inferences about intervention effects (Brown et al. 2007).”

• cites Kellam et al. 1999 sourceNot checked — no full text of the source
• cites Brown et al. 2007Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The intervention group (n=111) and control group (n=115) were balanced on gender, race/ethnicity, and grade level.

“The intervention group (n=111) and control group (n=115) were balanced on gender, race/ethnicity, and grade level.”

May combine two claims.

Problems in multiple domains further elevate the risk of future mental health disorders, substance abuse problems and need for services.

“and evidence that problems in multiple domains further elevate that risk (Kellam et al. 1982).”

• cites Kellam et al. 1982Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

To address this imbalance in the second year, children in the same classroom were stratified by baseline behavior control and gender before being randomly assigned to intervention or control condition.

“To address this imbalance in the second year, children in the same classroom were stratified by baseline behavior control and gender before being randomly assigned to intervention or control condition.”

May combine two claims.

The study was a waitlisted randomized trial of 226 kindergarten-3rd grade children identified with elevated behavioral and social classroom problems from a population-based screening.

“Two-hundred twenty-six kindergarten—3rd grade children identified with elevated behavioral and social classroom problems from a population-based screening participated in a waitlisted randomized trial of the Rochester Resilience Project derived from this model.”

May combine two claims.

Rates of suspensions increase in proportion to the seriousness of behavior problems measured through other methods, suggesting their utility as an indicator of conduct problems.

“Rates of suspensions increase in proportion to the seriousness of behavior problems measured through other methods (e.g., Huisinga and Jakob-Chien 1998), suggesting their utility as an indicator of conduct problems.”

• cites Huisinga and Jakob-Chien 1998Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Studies correlating the T-CRS with the longer Achenbach CBCL suggest adequate convergent and divergent concurrent validity.

“Studies correlating the T-CRS with the longer Achenbach CBCL suggest adequate convergent and divergent concurrent validity (Perkins and Hightower 2000).”

• cites Perkins and Hightower 2000Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Problems in behavioral, social-emotional, and/or on-task learning domains predict future mental health disorders, substance abuse problems and need for services.

“This population was selected due to evidence that those problems predict future mental health disorders, substance abuse problems and need for services (Jones et al. 2002)”

• cites Jones et al. 2002 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

After enrollment but before the intervention began, 13.4% of children were lost to attrition: 23 (8.8%) relocated to other schools and 12 (4.6%) were assigned to special education classrooms, which precluded their continued participation.

“After enrollment but before the intervention began, 13.4% of children were lost to attrition: 23 (8.8%) relocated to other schools and 12 (4.6%) were assigned to special education classrooms, which precluded their continued participation.”

May combine two claims.

There were no differences on any baseline measure between children who enrolled in the first or second year, suggesting that the change in teacher screening measure did not introduce a difference in children enrolling in year 1 versus year 2.

“There were no differences on any baseline measure (see below) between children who enrolled in the first or second year, suggesting that the change in teacher screening measure did not introduce a difference in children enrolling in year 1 versus year 2.”

Classified as probably not a substantial claim.

Strengthening children's adoption and generalization of skills may increase intervention effectiveness.

“suggesting that strengthening children’s adoption and generalization of skills may increase their effectiveness.”

• AssumptionRests on an assumption: Few skill-focused interventions have demonstrated long-term generalized benefits.

Probably not a substantial claim: may not pass S3 (load-bearing).

In our sample, internal reliability of T-CRS subscales ranged from 0.80-0.94.

“In our sample, internal reliability of subscales ranged from 0.80–0.94.”

Probably not a substantial claim: may not pass S3 (load-bearing).

None of the remaining 226 children were lost to attrition after the intervention started.

“None withdrew for other reasons, and none of the remaining 226 children were lost to attrition after the intervention started.”

Probably not a substantial claim: may not pass S3 (load-bearing).

T-CRS subscales have moderate stability over a 2-3 year period based on ratings of the same child by different independent raters.

“and moderate stability of over a 2–3 year period based on ratings of the same child by different independent raters (Wyman et al. 1993).”

• cites Wyman et al. 1993 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Once enrolled, children were stratified by gender and randomized within classrooms using computer generated pseudo-random numbers to either immediate intervention or to a wait-list for later intervention.

“Once enrolled, children were stratified by gender and randomized within classrooms using computer generated pseudo-random numbers to either immediate intervention or to a wait-list for later intervention.”

Probably not a substantial claim: may not pass S3 (load-bearing).

T-CRS subscales have one-month test-retest coefficients ranging from 0.80-0.90.

“One-month test-retest coefficients for T-CRS subscales range from 0.80–0.90 (Hightower et al. 1986)”

• cites Hightower et al. 1986 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

We conducted analyses comparing children who completed follow-up with those who were missing to determine whether attrition might have differentially affected intervention and control groups.

“To determine whether attrition might have differentially affected intervention and control groups, we conducted analyses comparing children who completed follow-up with those who were missing.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Teachers' knowledge of children's status could have influenced their propensity to refer children to school administrators to address behavior concerns.

“Although school records for disciplinary referrals were another source of information, teachers’ knowledge of children’s status could have influenced their propensity to refer children to school administrators to address behavior concerns.”

Probably not a substantial claim: may not pass S3 (load-bearing).

We tested baseline equivalence of intervention and control groups using ordinary t tests, chi-square tests, and logistic regressions.

“We tested baseline equivalence of intervention and control groups using ordinary t tests for continuous measures, chi-square tests for categorical variables, and logistic regressions for dichotomized count data.”

May combine two claims.

The intervention had a positive impact on children's classroom behaviors and rates of disciplinary incidents, including improved behavior control, on-task learning behaviors and peer social skills, and less shy-withdrawn and more assertive behaviors.

“The intervention had a positive impact on children’s classroom behaviors and rates of disciplinary incidents, including improved behavior control (i.e., fewer aggressive-disruptive problems), on-task learning behaviors and peer social skills, and less shy-withdrawn and more assertive behaviors.”

Classified as probably not a substantial claim.

All analyses used an intent-to-treat approach.

“All analyses used an intent-to-treat approach.”

May combine two claims.

Subscales of the AML-R and T-CRS covering related constructs are moderately correlated, and both measures have been extensively used in evaluating school-based programs in the U.S.; age and gender norms for both measures have been established for urban, suburban, and rural settings.

“Subscales of the AML-R and T-CRS covering related constructs are moderately correlated, and both measures have been extensively used in evaluating school-based programs in the U.S.; age and gender norms for both measures have been established for urban, suburban, and rural settings (Cowen et al. 1996).”

• cites Cowen et al. 1996 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Our analyses of intervention impact took into account the nesting of children within classrooms that are further nested within schools.

“Our analyses of intervention impact took into account the nesting of children within classrooms that are further nested within schools.”

Classified as probably not a substantial claim.

We used a three-level linear mixed-effects model with level 1 individual covariates, level 2 classroom variability, and level 3 school variability.

“To examine intervention impact on continuous data we used a three-level linear mixed-effects model (LMM), with level 1 including individual covariates (sex, grade, race/ethnicity), level 2 accounting for classroom variability and level 3 adjusting for variability across schools.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In prior skill-based interventions, young children with conduct problems and coexisting anxiety/depression problems have fared better in some short-term intervention studies.

“In prior skill-based interventions to address behavior problems, for example, young children with conduct problems and coexisting anxiety/depression problems have fared better in some short-term intervention studies (Beauchaine et al. 2005).”

• cites Beauchaine et al. 2005 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

An important aspect of this model is providing opportunities for children to practice skills in 'hot cognition' contexts to promote transfer of new learning, which also requires reinforcement by adults.

“An important aspect of this model is providing opportunities for children to practice skills in ‘hot cognition’ contexts (Damasio 1994) to promote transfer of new learning, which also requires reinforcement by adults.”

• cites Damasio 1994Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Formal disciplinary incidents and suspensions are associated over time with lower academic achievement and school bonding and with increased conduct problems.

“which are associated over time with lower academic achievement and school bonding and with increased conduct problems (Bryant et al. 2000; Huisinga and Jakob-Chien 1998).”

• cites Bryant et al. 2000 sourceFetching the cited paper…
• cites Huisinga and Jakob-Chien 1998Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

In-vivo practice is aimed at increasing a child's proceduralized skill in contexts in which hot cognition is activated.

“‘In-vivo’ practice is aimed at increasing a child’s proceduralized skill (Sun 1997) in contexts in which ‘hot cognition’ is activated (Damasio 1994) and experience in applying those skills in diverse interpersonal contexts.”

• cites Sun 1997 sourceNot checked — no full text of the source
• cites Damasio 1994Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Currently, approximately one in eight children with an emotional or behavioral disorder ever receive treatment in the mental health system.

“Currently, approximately one in eight children with an emotional or behavioral disorder ever receive treatment in the mental health system (O’Connell et al. 2009);”

• cites O’Connell et al. 2009Not checked — no full text of the source

May combine two claims.

Forcing a Poisson model to fit such data would bias the expected number of counts and mask the non-risk subgroup.

“Because forcing a Poisson model to fit such data would bias the expected number of counts and mask the non-risk subgroup, we employed an alternative approach to account for the presence of structural zeros in the analysis.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Rate of enrollment was comparable in both years.

“Rate of enrollment was comparable in both years.”

May combine two claims.

This type of classroom blocked design allowed us to hold fixed teacher and classroom context effects in examining impact and is efficient in statistical power.

“This type of classroom blocked design allowed us to hold fixed teacher and classroom context effects in examining impact and is efficient in statistical power (Brown and Liao 1999).”

• cites Brown and Liao 1999 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Teachers completed the C-TRS a second time four months later for all children enrolled in their classroom, without reference to their initial ratings for each child.

“Teachers completed the C-TRS a second time four months later for all children enrolled in their classroom, without reference to their initial ratings for each child.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Attendance of teachers at bi-monthly updates was nearly 100%.

“Attendance of teachers was nearly 100%.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Self-monitoring of feelings is an active process requiring attention, which can be learned.

“This definition suggests that self-monitoring of feelings is an active process requiring attention, which can be learned.”

• cites LeDoux 1998Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

An appropriate model for count responses in the presence of structural zeros is the zero-inflated Poisson (ZIP) regression.

“An appropriate model for count responses in the presence of structural zeros is the zero-inflated Poisson (ZIP) regression (Lambert 1992; Kowalski and Tu 2007).”

• cites Lambert 1992 sourceNot checked — no full text of the source
• cites Kowalski and Tu 2007 sourceNot checked — no full text of the source

May combine two claims.

Evidence that the intervention reduced serious behavior problems was strengthened by the reduction in suspensions, in addition to reducing more frequently occurring office referrals.

“Evidence that the intervention reduced serious behavior problems was strengthened by the reduction in suspensions, in addition to reducing more frequently occurring office referrals.”